Sacrificial of unilateral vertebral artery for fragment removal following vertebral artery injury by air rifle pellet gunshot: A case report

Abstract This report demonstrates the safety and efficacy of sacrificing a ruptured vertebral artery (VA) due to an air rifle pellet gunshot injury. A 15-year-old male was admitted with a gunshot wound to the neck. He was initially treated at Madiun General Hospital before referral. He exhibited stable vital signs and no neurological deficits. Imaging revealed a pellet in the right transverse foramen of the fifth cervical vertebra, causing a pseudoaneurysm of the right common carotid artery and occlusion followed by rupture of the right VA, with a patent left VA. Open surgery extracted the pellet, and a coil occlusion of the right VA was performed to control bleeding. The case underscores the importance of interdisciplinary collaboration and thorough examination in managing complex injuries, highlighting the safety of sacrificing a ruptured unilateral VA.